The Ann and Robert H. Lurie Children’s Hospital of Chicago has created LCAST, an app to help identify bruises on children under 4 years old that may indicate child abuse. The interactive 3D rotating model of a child allows researchers to note the body parts where bruises are found. After answering questions about the symptoms and the injury, the researcher is given a result that indicates whether the bruise could have occurred as a result of abuse or an accident. LCAST is based on reliable evidence and can be used by clinicians in emergency departments, paramedics, and social workers.
The Ann and Robert H. Lurie Children’s Hospital of Chicago has developed a new application called LCAST (Lurie Children’s Child Injury Plausibility Assessment Support Tool), aimed at identifying bruises in children under 4 years old that may derive from child abuse. With over 600,000 children in the US experiencing abuse each year, LCAST hopes to enhance the process of recognizing bruises and aiding decision-making when abuse is suspected.
The press release emphasized that physical abuse bruises in young children are often overlooked, which can lead to fatalities. LCAST considers various factors related to bruising to support evidence-based decision-making. The app cannot serve as a tool for diagnosis, but it can assist researchers in determining the instances that require more serious attention.
Mary Clyde Pierce, MD, an emergency medicine physician at Lurie Children’s and a professor of pediatrics and preventive medicine at Northwestern University Feinberg School of Medicine, highlighted that bruising on a young child is often dismissed as a minor injury, but it can be an early sign of child abuse. Early recognition of child abuse is critical, as abuse tends to escalate, and earlier recognition can save children’s lives.
The structure of LCAST consists of an interactive 3D rotating model of a child that allows researchers to note the body parts where the bruises are. After answering questions regarding any additional symptoms and the injury event, the researcher is given a result based on the patient’s information that notes whether the bruise could have occurred as a result of abuse or an accident.
LCAST was created using evidence from research that received funding from the National Institutes of Health (NIH). Under Pierce’s direction, this study improved and validated TEN-4-FACESp, a clinical decision rule for bruising that indicates the parts of the body where abuse is most likely to cause bruising. Slingshot and BioDigital partnered with Pierce and Kim Kaczor, a senior research scientist at Lurie Children’s, to develop the app.
To assess TEN-4-FACESp, Pierce, Kaczor, and other colleagues conducted a study examining more than 21,000 children, all under the age of 4, who had been to five different pediatric emergency departments. After enrolling 2,161 patients with bruising, researchers determined that TEN-4-FACESp had a 95 percent sensitivity and an 87 percent specificity, indicating that the tool could accurately differentiate bruising types.
The app screening tool is designed to capture potential abuse without over capturing innocent cases of children with bruising caused by accidental or incidental injuries. LCAST is founded on extremely trustworthy data and is applicable enough for clinicians working in emergency rooms, paramedics, Department of Children and Family Services social workers, and during any clinical interaction.
As the prevalence of smartphones and their applications continues to grow, research indicates how this technology can play a critical role in healthcare. Research presented at the American Stroke Association’s International Stroke Conference 2023 in February indicated that a smartphone application could leverage machine-learning algorithms to reveal stroke symptoms. Known as FAST.AI, the app uses video to recognize facial asymmetry, sensors to determine arm weakness, and voice recordings to identify speed changes. This data is critical in determining whether a patient is experiencing stroke symptoms. The speed at which this occurs through the app could allow for more timely treatment.